Risk factors for leakage following intestinal anastomosis in dogs and cats: 115 cases (1991-2000)

OBJECTIVE: To identify factors associated with leakage following intestinal anastomosis in dogs and cats. DESIGN: Retrospective study. ANIMALS: 90 dogs and 25 cats. PROCEDURE: Medical records of all dogs and cats that underwent intestinal resection and anastomosis between 1991 and 2000 were reviewed, and information on 27 factors was recorded. RESULTS: Anastomotic leakage was identified in 13 of the 90 dogs but in none of the 25 cats. Preoperative factors significantly associated with development of anastomotic leakage in dogs included preoperative peritonitis, serum albumin concentration, a left shift, and indication for surgery (dogs with intestinal foreign bodies were more likely to have leakage than dogs that underwent surgery for any other cause). Postoperative and case management factors significantly associated with development of leakage included duration of hospitalization, supplemental alimentation, whether the dog ate the day after surgery, blood product administration, and outcome (died vs survived). Discriminant analysis was performed, and dogs with 2 or more of the following factors were predicted to develop anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration < or = 2.5 g/dL. The model accurately predicted whether leakage would develop in 67 of 80 (84%) dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a variety of factors may be associated with development of intestinal anastomotic leakage in dogs. In particular, dogs with 2 or more of the following risk factors are predicted to be at high risk for developing anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration < or = 2.5 g/dL.     

The Role of Bronchoscopy in Foreign Body Removal in Dogs and Cats: 37 Cases (2000–2008)

Background: Foreign body aspiration is a differential diagnosis for acute or chronic cough that requires medical or surgical management in animals. Hypothesis: Success of bronchoscopy in airway foreign body removal is dependent on the size of the animal, duration of clinical signs, and location of the foreign body. Animals: Thirty‐two dogs and 5 cats with airway foreign bodies identified at the UC Davis Veterinary Medical Teaching Hospital. Methods: Retrospective case study evaluating the role of duration of clinical signs and body size in successful bronchoscopic removal of foreign bodies. In addition, radiographic localization of disease was compared with bronchoscopic identification. Bronchoalveolar lavage (BAL) culture and cytologic findings are reported. Results: Bronchoscopy was successful for removal of airway foreign bodies in 76% of animals (24/28 dogs and 2/5 cats), and in dogs was independent of duration of clinical signs or body size. One‐third of thoracic radiographs lacked distinctive features of an airway foreign body, and therefore radiography was unable to predict the affected site. BAL fluid at the site of the foreign body contained more neutrophils and more often had intracellular bacteria than lavage fluid from a separate site. Conclusions and Clinical Importance: Bronchoscopy was successful in removing airway foreign bodies regardless of animal size or long duration of clinical signs. Results of this study confirm the utility of bronchoscopy with lavage in management of suspected foreign bodies, even in the absence of localizing radiographic findings.     

Gastrointestinal foreign bodies in dogs and cats: a retrospective study of 208 cases

O bjectives : To establish predilection sites of obstruction and to investigate clinical factors associated with a poor outcome.
M ethods : A retrospective study of 208 consecutive cases over a 48-month period from first-opinion practice.
R esults : Overall, 91 per cent of cases recovered with higher survival rates from discrete foreign bodies (94 per cent in dogs and 100 per cent in cats) as opposed to linear foreign bodies (80 per cent in dogs and 63 per cent in cats). English bull terriers, springer spaniels, Staffordshire bull terriers, Border collies and Jack Russell terriers were over-represented. In dogs, 63 per cent of obstructions occurred in the jejunum but foreign objects were encountered at all points along the gastrointestinal tract. A longer duration of clinical signs, the presence of a linear foreign body and multiple intestinal procedures were associated with significantly increased mortality. Neither the degree of obstruction (partial or complete) nor the location of the foreign body was shown to have a significant influence on survival.
C linical S ignificance : Prompt presentation, diagnosis and surgical intervention improve the outcome of gastrointestinal obstruction by foreign bodies. At surgery, the minimal number of intestinal procedures should be performed to restore the integrity of the alimentary tract.     

CT findings in 20 dogs and six cats with confirmed nasal foreign bodies

The diagnosis and treatment of nasal foreign bodies usually includes a combination of rhinoscopy and imaging techniques, such as CT. The purpose of this retrospective, multicenter study was to describe the CT characteristics of nasal foreign bodies in dogs and cats and to determine if different nasal CT features exist between acute and chronic cases. Twenty dogs and six cats met the inclusion criteria. Eleven nasal foreign bodies (42%) were detected confidently with CT. The foreign body had a linear shape in 81% of cases and displayed a “tubular‐like appearance” in 54% of cases. In five cases (19%), a foreign body was suspected but not clearly visible. Additional CT changes were present in the nasal passages in 96% of the cases. The presence of turbinate destruction (P = .021) and mucosal thickening (P = .014) on CT were associated with the presence of a chronic nasal foreign body. In this sample, the nature of the foreign body did not influence its visibility and was not associated with specific CT characteristics. Computed tomography may be useful in the investigation of nasal foreign bodies, however, a negative CT examination does not exclude their presence.     

Endoscopic examination of the choanae in dogs and cats: 118 cases (1988-1998).

OBJECTIVE: To determine whether endoscopic examination of the choanae resulted in diagnosis of various diseases in dogs and cats with signs of respiratory tract disease. DESIGN: Retrospective study. ANIMALS: 91 dogs and 27 cats that had endoscopic examination of the choanae. PROCEDURE: Medical records were reviewed for endoscopy findings and results of examination of biopsy or cytologic specimens. RESULTS: 34 animals had neoplasia in the choanal region; in 26 animals, diagnosis was confirmed by evaluation of specimens obtained by endoscopy. Five dogs with neoplasia had an erroneous diagnosis of rhinitis made on the basis of evaluation of specimens obtained by endoscopy. Six dogs and 2 cats had foreign objects in the choanae; 7 foreign objects were removed endoscopically, whereas 1 required nasal flushing. Results of endoscopy and biopsy of the choanae provided diagnosis of cryptococcosis and aspergillosis, but did not aid in the diagnosis of pythiosis or nasal mites. CONCLUSIONS AND CLINICAL RELEVANCE: Endoscopic examination of the choanae may assist in rapid diagnosis of nasal neoplasms, foreign objects, and certain infectious organisms.     

SURVEY OF THE USE OF RADIOGRAPHY VS. ULTRASONOGRAPHY IN THE INVESTIGATION OF GASTROINTESTINAL FOREIGN BODIES IN SMALL ANIMALS

A question frequently asked by clinicians who are treating small animals suspected of having gastrointestinal foreign bodies is whether one imaging test such as survey radiography or ultrasonography is sufficient to make the diagnosis. A study was undertaken to try and answer this question. Survey abdominal radiography and ultrasonography was performed on 16 small animals (11 dogs, five cats) with clinical signs of an obstruction because of a confirmed gastrointestinal foreign body. The majority of the foreign bodies (14/16) were confirmed by surgical removal and were located in the small intestine. A gastric foreign body was retrieved endoscopically and a colonic foreign body was passed in the feces. Radiographically identifiable foreign bodies were evident in nine animals. Small intestinal overdistension was present radiographically in seven animals. Ultrasonography detected a foreign body in all 16 animals. The foreign bodies were identified by their distal acoustic shadowing and variable degrees of surface reflection. An intestinal perforation was detected sonographically but not radiographically. The value of additional sonographic findings including thickening of the gastrointestinal wall and loss of layering, free peritoneal fluid, and lymphadenopathy in these animals is discussed. The findings in this series suggest that in a small animal with a gastrointestinal foreign body, ultrasonography alone could be used to make the diagnosis and may be a more appropriate choice than survey radiography.     

Gastroduodenoscopy in the dog and cat.

Endoscopic examination of the upper gastrointestinal (GI) tract in dogs and cats is a relatively recent development. It was just over 20 years ago, in 1978, that the first series report of GI endoscopy in dogs and cats was presented. In those initial days, endoscopy was truly a novelty, and the primary uses for endoscopes were to retrieve foreign objects or visualize the esophagus and stomach. It was not until the mid-1980s that technology and training made gastroduodenoscopy standard practice. The evolution in endoscopic technology has also mirrored the evolution in computers and imaging modalities. The original fiberoptic endoscopes, although still available, are giving way to video endoscopy and digital imaging capabilities that provide spectacular images and an ability to generate hard copy images for medical records, teaching purposes, and research data that was previously not possible.     

Extensive small bowel resection in dogs and cats: 20 cases (1998-2004)

OBJECTIVE: To determine outcome in dogs and cats that underwent extensive (ie, > 50%) resection of the small intestine and identify factors associated with outcome. DESIGN: Retrospective case series. ANIMALS: 13 dogs and 7 cats. PROCEDURE: Medical records were reviewed, and follow-up information was obtained. RESULTS: In all 7 cats and in 8 of the 13 dogs, extensive intestinal resection was performed because of a foreign body. Mean+/-SD estimated percentage of intestine that was removed was 68+/-14% (range, 50% to 90%). Two dogs were euthanized 3 days after surgery because of dehiscence of the surgical site and development of septic peritonitis; 1 dog died of acute respiratory distress syndrome 5 days after surgery. The remaining 10 dogs and 7 cats were discharged from the hospital, and follow-up information was available for 15 of the 17. Median survival time was 828 days, and 12 of the 15 animals for which long-term follow-up information was available had good outcomes. However, none of the factors examined, including percentage of intestine resected, were significantly associated with outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Most dogs and cats that underwent extensive resection of the small intestine had a good outcome. The amount of intestine resected was not associated with outcome. These data may be useful in providing prognostic information in cases of extensive small intestinal resection.     

Epidemiological features of snail and slug bait poisoning in dogs and cats

Snail and slug baits were the most common cause of poisoning in dogs and cats in a survey of 34 veterinary practices. During a 7-month period, 280 dogs and 12 cats were poisoned by metaldehyde (57%) or methiocarb (43%) containing baits with case fatality rates of 8.1% and 9.1% in dogs and 16.7% and 50% in cats, respectively. The ages of poisoned dogs ranged from 2 months to 17 years and cats from 3 months to 5 years. There was no decrease in frequency of poisoning or case fatality rate demonstrated with increasing body size in dogs. Poisoning was most frequent in the month of October. Baits were eaten off the ground or obtained from storage areas, often despite a variety of preventive measures. It is suggested that these products should be reformulated to make them less attractive to domestic pets.     

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.     

Ketoconazole in the treatment of dermatomycosis in cats and dogs

Ketoconazole (Nizoral, Janssen Pharmaceutica) a new systemic antimycotic was tested in dermatomycosis in cats and dogs. The daily dose (10 mg/kg body weight) was administered for 10 or 20 days without any other measures being taken. After the 20-day treatments new hair growth was observed in 96.7 per cent of the cats and 89.9 per cent of the dogs. Clinical cure was complete in 96.8 per cent of the cats and 90.5 per cent of the dogs. Particularly the good tolerance in the cat was appreciated. There were practically no side-effects in dogs (except vomiting in two pups) or in cats.     

Dog bite wounds in dogs and cats: a retrospective study of 196 cases

The age, type, etc., time of injury, body areas injured, treatment modalities and mortality rates were reviewed in 185 dogs and 11 cats that were bitten by dogs. Male dogs were more frequently bitten than females, and small dogs (< or = 10 kg) were not only the most common victims but also were more likely to suffer multiple injuries. Mortality occurred only in cases with thoracic or abdominal injuries. Exploratory thoracotomy, performed in some of the cases presented with penetrating thoracic injury, did not prove to alter prognosis. Cats are not as frequently bitten as dogs, and are often younger than the mean age of cats in the overall hospital population.     

Evaluation of peripheral and central venous pressure in awake dogs and cats

OBJECTIVE: To determine whether peripheral venous pressure (PVP) was correlated with central venous pressure (CVP) when measured by use of different catheter sizes, catheterization sites, and body positions in awake dogs and cats. ANIMALS: 36 dogs and 10 cats. PROCEDURES: Dogs and cats with functional jugular and peripheral venous catheters were enrolled in the study. Peripheral venous catheters (18 to 24 gauge) were placed in a cephalic, lateral saphenous, or medial saphenous vein. Central venous catheters (5.5 to 8.5 F) were placed in the jugular vein and advanced into the cranial vena cava. Catheters were connected to pressure transducers and a blood pressure monitor capable of displaying 2 simultaneous pressure tracings. For each animal, the mean of 5 paired measurements of PVP and CVP was calculated. The relationship between PVP and CVP when measured by use of different catheter sizes, catheterization sites, and body positions was determined. RESULTS: Mean +/- SD PVP was 5.7 +/- 5.8 mm Hg higher than CVP in dogs and 6.0 +/- 6.9 mm Hg higher than CVP in cats. However, results of multiple regression analysis did not indicate a significant correlation between PVP and CVP, regardless of catheter size, catheter position, or body position. The relationship was weak in both dogs and cats. CONCLUSIONS AND CLINICAL RELEVANCE: The PVP was poorly correlated with CVP when different catheter sizes, catheterization sites, and patient positions were evaluated. Peripheral venous pressure should not be used to approximate CVP in awake dogs and cats.     

ULTRASONOGRAPHIC FINDINGS IN DOGS AND CATS WITH GASTROINTESTINAL PERFORATION

A retrospective study was performed to evaluate the sonographic features of gastrointestinal (GI) perforation in dogs and cats. Sonographic findings in 19 animals (14 dogs and 5 cats) included regional bright mesenteric fat (19), peritoneal effusion (16), fluid-filled stomach or intestines (12), GI wall thickening (11), presence of free air (9), loss of GI wall layering (9), regional lymphadenopathy (8), reduced GI motility (7), pancreatic changes (4), corrugated intestines (4), presence of a mass (3), presence of a foreign body (3), and mineralization of the gastric wall (1). In 14 patients, "perforation" was listed as a differential diagnosis by the sonographer. Abdominal radiographs and radiographic reports were available for 14 patients. Radiographic findings were decreased serosal detail (12), free air (8), peritoneal contrast medium (1), and suspected foreign body (1). GI perforation was listed as radiographic diagnosis in eight patients, seven of which had evidence of pneumoperitoneum, and one had leakage of contrast material on an upper GI study. In 9/14 patients with radiography, "GI perforation" was listed as a sonographic diagnosis. In three patients in which free air was diagnosed sonographically, radiographs were either not available (2) or the presence of free air was not detected at presentation (1). Peritoneal fluid analysis was performed in nine patients, five of which were identified as septic inflammation, and the remaining four were classified as neutrophilic inflammation with no etiologic agent identified. The histologic or surgical diagnoses were as follows: three intestinal surgical dehiscence; one percutaneous endoscopic gastrostomy tube site leakage; one duodenal adenocarcinoma; one ileocolic lymphoma; one trichobezoar; one ascarid impaction; and one bobby pin foreign body. In the remaining 10 patients, a focal area of gastric/intestinal ulceration or transmural necrosis with perforation was identified without evidence of an underlying cause.     

ULTRASONOGRAPHIC DIAGNOSIS OF FOREIGN BODIES ASSOCIATED WITH CHRONIC DRAINING TRACTS AND ABSCESSES IN DOGS

This is a retrospective study that describes the historical, physical exam, radiographic, fistulographic, ultrasonographic, and surgical findings associated with non-gastrointestinal and extrathoracic foreign bodies in six dogs. All dogs had a chronic draining tract or abscess. Although radiographs were obtained in five of the six dogs, no foreign bodies were identified with this modality. Fistulography was performed in four of the six dogs, and a filling defect consistent with a foreign body was found in two of four dogs. A foreign body was identified in five of the six dogs with ultrasound. Foreign bodies were removed surgically in five of six dogs. This report clarifies the importance of ultrasound in the evaluation of chronic draining tracts and abscesses in dogs.     

Ketoconazole in the treatment of dermatomycosis in cats and dogs

Ketoconazole (Nizoral^®, Janssen Pharmaceutica) a new systemic antimycotic was tested in dermatomycosis in cats and dogs. The daily dose (10 mg/kg body weight) was administered for 10 or 20 days without any other measures being taken. After the 20‐day treatments new hair growth was observed in 96.7 per cent of the cats and 89.9 percent of the dogs. Clinical cure was complete in 96.8 per cent of the cats and 90.5 per cent of the dogs.

Particularly the good tolerance in the cat was appreciated. There were practically no side‐effects in dogs (except vomiting in two pups) or in cats.     

Evaluation of the utility and accuracy of body fluids containing red blood cells to determine canine and feline blood types

Objective

To examine the accuracy of using body fluids macroscopically suspected to contain erythrocytes to determine the blood type in dogs and cats by use of an immunochromatographic cartridge (ICC), compared to systemic blood as the reference standard.

Design

Prospective study.

Setting

University teaching hospital.

Animals

Thirty client-owned dogs and 8 cats.

Interventions

Dogs and cats with a sanguineous or serosanguineous body fluid (SBF) that also required a blood sample were eligible for inclusion. PCV and blood type were determined in all blood and fluid samples. For body fluids with a low PCV and discordant blood type results compared to systemic blood, sample concentration and repeat blood typing from the fluid was performed when enough sample was available.

Measurement and Main Results

Body fluid samples consisted of 16 pleural (11 dogs; 5 cats), 12 peritoneal (10 dogs; 2 cats), and 4 canine pericardial effusions, 3 urine samples, and 1 each of feces and epistaxis from dogs and a seroma sample from a cat. Median (range) manual PCV of blood and fluid samples was 34% (14%–66%) and 6% (0.5%–70%) for dogs and 28% (14%–48%) and 14% (0.5%–19%) for cats, respectively. Dogs were correctly classified as being DEA 1 negative, DEA 1 positive, and DEA 1 weak positive when using body fluid for blood typing 13 of 14, 4 of 9, and 5 of 7, respectively. All reference blood type to fluid blood type (FBT) discordant results had a body fluid PCV equal to or below 2%. Subsequently concentrated body fluid samples had a PCV above 8% and repeat FBT matched reference blood type (RBT). All cats were classified as type A by all RBTs and FBTs.

Conclusions

Body fluids containing erythrocytes may be utilized to blood type dogs if sufficiently concentrated and type A cats.     

Asymmetrical focal neurological deficits in dogs and cats with naturally occurring tick paralysis (Ixodes holocyclus): 27 cases (1999-2006)

OBJECTIVE: To describe basic epidemiological features, clinical characteristics and outcomes of asymmetrical focal neurological deficits identified in dogs and cats with naturally occurring tick paralysis (Ixodes holocyclus). DESIGN: A retrospective study. PROCEDURE: Computer records were reviewed for all dogs and cats treated for tick paralysis between July 1999 and June 2006 at a suburban veterinary hospital in Newcastle, New South Wales. RESULTS: Neurological deficits were identified in 17/197 dogs and 10/89 cats and included unilateral facial paralysis (14 dogs; 2 cats), anisocoria (4 dogs; 7 cats), unilateral loss of the cutaneous trunci reflex (1 dog; 1 cat) and Horner's syndrome in 2 cats with anisocoria. Occurrence of deficits was not linked to season, severity of tick paralysis, breed, age, sex or body weight. With facial paralysis and anisocoria, the site of tick attachment was invariably on the head or neck and always ipsilateral to the facial paralysis. By contrast, with anisocoria alone, no consistent relationship was noted between any one pupillary dimension and the side of tick attachment. With cutaneous trunci deficits the site of tick attachment was the ipsilateral caudal axilla. Compared with recovery times from generalised signs of tick paralysis, those for facial paralysis were significantly longer (days to weeks; P < 0.001), those for anisocoria showed no significant difference (P = 0.25) and those for cutaneous trunci deficits lagged by 6 and 7 days. CONCLUSIONS: Asymmetrical focal neurological deficits are a consistent finding in a proportion of dogs and cats with naturally occurring tick paralysis due to I. holocylcus.     

Gastric neoplasia.

Gastric tumors are rare in dogs and cats but should always be considered, particularly in older dogs with chronic vomiting. The most common gastric tumor in dogs is carcinoma, although lymphoma is rare. Breeds that seem to be predisposed to gastric carcinoma are the Rough Collie, Staffordshire Terrier, and Belgian Shepherd. Lymphoma is the most common gastric malignancy in cats. Contrast radiographic examination and endoscopy are the elective procedures of choice for the diagnosis of these conditions. Biopsy is essential to confirm the diagnosis. Surgery is the only potentially curative modality for localized gastric carcinoma. Chemotherapy alone or following surgery is the elective treatment of choice for gastric lymphoma in dogs and cats. The prognosis is poor for both types of tumor, but prolonged survival times in individual animals are possible.     

Sensitivity and specificity of cytologic evaluation in the diagnosis of neoplasia in body fluids from dogs and cats

Sensitivity and specificity were determined for the cytologic detection of malignant tumors in canine and feline body cavity effusions. In a prospective study, 424 body cavity effusions from dogs and cats were collected and evaluated, including 70 pleural and 163 peritoneal effusions from dogs, and 77 pleural and 114 peritoneal effusions from cats. Final diagnoses were confirmed in 339 of the 424 cases by clinical follow-up, necropsy, and in the case of malignant tumors, Histopathology. Malignant tumors were found in 18% of canine and 25% of feline body cavity effusions. Approximately one-half of tumors in both dogs and cats were carcinomas. Discrete cell tumors accounted for 56% of feline neoplastic effusions. The sensitivity of cytologic evaluation for the detection of malignant tumors in body cavity effusions was 64% for dogs and 61% for cats. Specificity was 99% for canine and 100% for feline effusions. Sensitivity and specificity were comparable to those obtained with cytologic evaluation of human samples.