Separation of the Auricular and Annular Ear Cartilages: Surgical Repair Technique and Clinical Use in Dogs and Cats

Objective— To report a surgical technique for primary repair of separation of the annular and auricular cartilages of the ear and long-term outcome.
Study Design— Case series.
Animals— Cats (3) and dogs (2) with ear canal separation.
Methods— Medical records (1998–2007) of dogs and cats with ear canal separation were reviewed. Long-term outcome was obtained by telephone interview of owners or referring veterinarians.
Results— Three cats and 1 dog had ear canal separation after being hit by a car; there was no history of trauma in 1 dog. Successful repair was achieved by a caudal approach to the ear canal, identifying and debriding separated cartilage edges and using primary repair. A patent ear canal was confirmed in all animals by otoscopy 4–12 weeks later and by ear canalography in 3 animals. Long-term outcome was excellent with no reported complications 10–90 months later (median 24 months).
Conclusions— Both acute and chronic separation between the annular and auricular cartilages, in the absence of middle ear disease, can be successfully treated using primary repair via a caudal approach to the ear canal, with excellent long-term outcome.
Clinical Relevance— Primary repair should be considered in animals with separation of the annular and auricular cartilages.     

Traumatic Coxofemoral Luxation In Dogs Results of Repair

The medical records of 171 dogs with traumatic hip luxations were examined. German shepherds, mixed breeds, and poodles were significantly overrepresented. The mean age of the patients at the time of diagnosis was 4.4 years (range 5 months to 14 years). Vehicular trauma caused 83% of the 133 luxations where the etiology was known; 53% had at least one other diagnosed traumatic injury. Long-term results were obtained from owner questionnaires (25 dogs) or clinical and radiographic examinations (11 hip joints). The short-term recurrence rate after closed reduction (47.3%) was higher than that after surgical reduction using any of the three surgical techniques most frequently used here (9.5, 12.5, and 14.3%), even when the operation was performed after failure of a closed reduction (11.8%). Excluding dogs that had a femoral head ostectomy, 68% (17 of 25) of the dogs had a normal gait, 16% had only a mild lameness, and 16% had more severe lameness when evaluated on an average of 31 months after repair. Of 11 hip joints radiographed on an average of 25 months following repair, five had no radio-graphic abnormalities related to the luxation and six showed one or more of the following: periosteal new bone formation, femoral head subluxation, partial resorption of the femoral head, periarticular osteophytes, and subchondral bone erosion. Closed reduction should be the initial treatment of choice in uncomplicated luxations even though the rate of reluxation is high, because it avoids the need for surgery in approximately one half of affected dogs and does not increase the recurrence rate following subsequent surgical reduction.     

Total Ear Canal Ablation Combined with Lateral Bulla Osteotomy for End-Stage Otitis in Dogs Results in Thirty Dogs

Thirty dogs with end-stage otitis were treated by either unilateral or bilateral total ear canal ablation and lateral bulla osteotomy. Otitis was considered end stage when the horizontal ear canal was collapsed, stenotic, or occluded in conjunction with chronic infection of the external and middle ear. The dogs were evaluated clinically and radiographically for 4 to 63 months. The frequency of scratching, head shaking, aural drainage, and para-aural fistulation was significantly decreased. Abnormal ear carriage and head tilt were not changed. The results in 23 dogs were graded as excellent or improved. One dog died of intraoperative hemorrhage. Complications during the period from suture removal to follow-up included para-aural fistulation (3 dogs), facial nerve paralysis (5 dogs), and head tilt (3 dogs).     

Femoral Head Fractures Resulting in Epiphyseal Fragmentation Results of Repair in Five Dogs

Five mature dogs with fragmented femoral head fractures were treated. Fracture reduction was accomplished with lagged cortex screws and Kirschner wires or Smilley nails. Results were good or excellent in four dogs. Rigid internal stabilization, early surgical treatment, and reduced activity postsurgically are essential for proper healing of these fractures.     

Fracture of the Supraglenoid Tubercle Treatment and Results in Five Horses

Five horses with fractures of the supraglenoid tubercle (tuber scapulae) were presented from 6 weeks to 1 year after injury. Clinical signs included lameness characterized by a shortened cranial phase of the stride and shoulder muscle atrophy. Radiographically, the fractures differed in the degree of cranioventral displacement of the fragment as well as the extent of joint involvement. Three horses were treated by resection of the fractured tubercle, including one using a new grid approach to the area of the fracture. Two of these horses have returned to athletic activity and one was euthanized due to postoperative infection. One horse with minimal displacement and joint involvement was treated with rest and raced successfully. One horse seen with a fracture of 1 year duration also was treated with rest and was a pasture sound broodmare.     

Surgical Treatment of Pheochromocytoma: Technique, Complications, and Results in Six Dogs

Six dogs were diagnosed with phcochromocyloma and staged according to the World Health Organization's system for tumor classification. Two dogs had benign tumors (Tl, NO, M0) and four dogs had malignant tumors (T2, NO. M 1 or T3, N0, M0). All dogs had adrenalectomy, two dogs had concurrent nephrectomy, and three dogs had concurrent resection of a tumor thrombus from the vena cava. Anesthetic complications occurred in five dogs, including wide variations in heart rate (four dogs), blood pressure (five dogs), and cardiac arrythmias (one dog). One dog died 12 hours after surgery from partial dehiscence of the suture line and hemorrhage from the vena cava, and one dog died 6 days after surgery during general anesthesia for treatment of laryngeal paralysis. Four dogs survived from 3 to 23 months (median, 15 months). One dog remained hypertensive after surgery. Benign and malignant pheochromocytomas seem to be amenable to surgical resection. © Copyright 1994 by The American College of Veterinary Surgeons     

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.     

Results of Partial Mandibulectomy for the Treatment of Oral Tumors in 142 Dogs

Partial mandibulectomy was performed for the treatment of benign or malignant oral tumors in 142 dogs. Forty-two dogs with a benign tumor (ameloblastoma) had a 22.5 month (range, 6 to 74 months) median disease-free interval, with a 97% 1-year survival rate; there was local recurrence in one dog. Twenty-four dogs with squamous cell carcinoma had a disease-free interval of 26 months (range, 6 to 84 months), with a 91% 1-year survival rate; recurrence and metastasis developed in two dogs and metastatic disease in one dog. Based on survival curves, 37 dogs with a melanoma had a median survival time of 9.9 months (range, 1 to 36 months), with a 21% 1-year survival rate; 20 dogs died or were euthanatized for recurrent or metastatic disease. Twenty dogs with osteosarcoma had a median survival time of 13.6 months (range, 3 to 28 months), with a 35% 1-year survival rate; nine dogs died or were euthanatized for recurrent or metastatic disease. Nineteen dogs with fibrosarcoma had median survival time of 10.6 months (range, 3 to 32 months), with a 50% 1-year survival rate; 12 dogs died or were euthanatized for recurrent or metastatic disease. Results of this and previous studies demonstrated that partial mandibulectomy was effective in prolonging survival and decreasing recurrence for squamous cell carcinoma and ameloblastoma. Progressive disease and corresponding low survival times were common in dogs with melanoma, osteosarcoma, and fibrosarcoma. There were no differences in survival times or the progression of disease among five partial hemimandibulectomy procedures. The high rates of recurrence and metastasis in dogs with these tumors suggest a need for evaluation of ancillary chemotherapy and local radiation therapy to decrease the prevalence of progressive disease.     

Clinical Features and Outcome of Dogs with Epiglottic Retroversion With or Without Surgical Treatment: 24 Cases

Background

Published information describing the clinical features and outcome for dogs with epiglottic retroversion (ER) is limited.

Hypothesis/Objectives

To describe clinical features, comorbidities, outcome of surgical versus medical treatment and long‐term follow‐up for dogs with ER. We hypothesized that dogs with ER would have upper airway comorbidities and that surgical management (epiglottopexy or subtotal epiglottectomy) would improve long‐term outcome compared to medical management alone.

Animals

Twenty‐four client‐owned dogs.

Methods

Retrospective review of medical records to identify dogs with ER that underwent surgical or medical management of ER.

Results

Dogs with ER commonly were middle‐aged to older, small breed, spayed females with body condition score (BCS) ≥6/9. Stridor and dyspnea were the most common presenting signs. Concurrent or historical upper airway disorders were documented in 79.1% of cases. At last evaluation, 52.6% of dogs that underwent surgical management, and 60% of dogs that received medical management alone, had decreased severity of presenting clinical signs. In dogs that underwent surgical management for ER, the incidence of respiratory crisis decreased from 62.5% before surgery to 25% after surgical treatment. The overall calculated Kaplan–Meier median survival time was 875 days.

Conclusion and clinical importance

Our study indicated that a long‐term survival of at least 2 years can be expected in dogs diagnosed with epiglottic retroversion. The necessity of surgical management cannot be determined based on this data, but dogs with no concurrent upper airway disorders may benefit from a permanent epiglottopexy to alleviate negative inspiratory pressures.     

Achilles Tendon Repair in Dogs Using the Semitendinosus Muscle: Surgical Technique and Short-Term Outcome in Five Dogs

Objective— To describe augmentation of primary Achilles tendon repair using suture with a semitendinosus muscle flap and report outcome in 5 dogs.
Study Design— Prospective clinical study.
Animals— Dogs (n=5) with Achilles tendon rupture (n=6).
Methods— After tendon repair with #2 polypropylene in a 3-loop pulley suture pattern, the lateral one-half of the semitendinosus muscle was transected from the ischium, rotated distally then sutured with #2 polypropylene to the calcaneus in a 3-loop pulley pattern. The epitenon was sutured to the muscle flap fascia with interrupted sutures. All dogs had a bivalved cast for 2 weeks then a cranial splint for 2–6 weeks. Lameness scores (0=stands and walks normally to 4=non-weight-bearing lameness, plantigrade stance on affected pelvic limb) were determined every 2–3 weeks postoperatively for 12 weeks. Outcome was determined from telephone questionnaire of owners.
Results— Four had lameness scores of 0, the 5th had a score of 1 at 12 weeks. Three owners were very satisfied with outcome. Minor complications included cast sores (2 dogs), infection (2), and acute swelling (1); 1 major complication occurred (infection resulting in reoperation).
Conclusions— Semitendinosus flap augmentation resulted in early return to function without prolonged postoperative immobilization. Three dogs returned to full work/activity after repair.
Clinical Relevance— Augmentation of primary Achilles tendon repair with a semitendinosus flap can be considered in dogs with chronic rupture but further investigation of the long-term outcome using this technique is needed.     

Treatment of Age‐Related Hearing Loss in Dogs with the Vibrant Soundbridge Middle Ear Implant: Short‐Term Results in 3 Dogs

Background: Age‐related hearing loss (ARHL), or presbycusis, is the most common form of acquired hearing loss in dogs. Middle ear implants have been used successfully in people with ARHL who cannot benefit from conventional hearing aids. Hypothesis: Audibility improves in dogs with ARHL after implantation of the Vibrant Soundbridge (VSB) middle ear implant. Animals: Three Beagle dogs with ARHL, mean age 11.1 years. Methods: The dogs were assessed pre‐ and postoperatively by brainstem‐evoked response audiometry (BERA), otoscopy, and computed tomography scans of the ears. A VSB middle ear implant was implanted unilaterally. Three months later the functionality of the implants was assessed by auditory steady‐state responses (ASSRs), after which the dogs were euthanized for histopathological examination. Results: The VSB was implanted successfully in all dogs. Recovery from surgery was uneventful, except for transient facial nerve paralysis in 2 dogs. ASSRs showed that hearing improved after activation of the implants with a mean of 20.7, 13, and 16.3 dB at 1, 2, and 4 kHz, respectively. The implantation procedure did not affect residual hearing (with inactive implants) as measured by BERA. Conclusions and Clinical Importance: Implantation of the VSB resulted in lower ASSR thresholds, but only at the higher gain settings of the audioprocessor. As in humans, a more powerful audioprocessor is required to treat sensorineural hearing loss exceeding 20 dB in dogs. A substantial improvement in patient‐owner communication will have to be demonstrated in future studies before the procedure can be recommended in clinical practice.     

Complications and Long-term Results after Partial Laryngectomy for the Treatment of Idiopathic Laryngeal Paralysis in 45 Dogs

Forty-five dogs with severe respiratory signs caused by idiopathic, acquired laryngeal paralysis were treated by partial laryngectomy. The predominant postoperative complications were coughing in 28 dogs and pneumonia in 15 dogs. Eight dogs required a second operation to alleviate persistent or recurrent upper airway obstruction. Results of surgery were considered excellent in 11 dogs (25%), good in 18 dogs (40%), fair in 6 dogs (13%), and poor in 10 dogs (22%). Poorer results were obtained by surgical residents than by more experienced surgeons. Death in the immediate postoperative period was related to pneumonia (8 dogs) and laryngeal collapse (1 dog). Nine dogs died later of respiratory disease. Although partial laryngectomy is effective for the treatment of laryngeal paralysis, it is not recommended because of the high incidence of postoperative complications.     

Synovitis Subsequent to Total-Hip Arthroplasty with and Without Hydroxyapatite Coatings: A Study in Dogs

OBJECTIVE: To establish whether hydroxyapatite (HA) coatings applied to metal total-hip-replacement components increased synovitis in the coxofemoral joint of dogs. Study Design-An in vivo research trial and histologic study. ANIMALS: Twenty-three large, mixed-breed dogs. METHODS: Arthroplasty components were implanted with HA on neither stem nor cup, or with HA applied to either the femoral component or with both stem and cup having HA applied in 23 dogs. Synovial inflammation was scored 3, 6, and 12 months after surgery. Synovial membrane thickness; polyethylene particulate load; fibrin exudate; membrane edema; mitotic index; giant-cell, mononuclear histiocyte, lymphocyte, and polymorph number; and collagen degeneration were scored and statistical analyses performed. RESULTS: Operated-side synovial thickness was greatly increased relative to control. Fibrin deposition, intramembranous edema, and collagen degeneration were similar within each time interval among the various component groups. The majority of inflammatory scores among the groups were unchanged. In this 12-month study, the presence of HA coatings appear not to have a marked impact on the development of synovial inflammation. CONCLUSIONS: HA-coated components do appear to contribute somewhat to the inflammatory load within the periprosthetic environment, but this effect is not marked. CLINICAL RELEVANCE: The major advantage of HA addition to arthroplasty components is enhanced osteoconductivity around metallic surfaces. The slight increase in particulate load seen in the presence of HA coatings may contribute to the development of aseptic loosening of arthroplasty components, but is unlikely to be the major causative factor.     

Radioimmunoassay of Plasma Insulin in Dogs and Monkeys: Application of the Dextran-coated Charcoal Separation Method

The coated-charcoal separation method of Herbert (10) for radioimmunological determination of insulin in plasma of dogs and monkeys was evaluated by recovery, dilution, and reproducibility experiments. When optimal conditions were maintained, the method was well suited for plasma insulin-assay in these animals. In normal dogs and monkeys, fasting concentrations of plasma insulin ranged from less than 0.078 to 1.0 ng/ml. Intravenous infusion of xylitol, glucose or tolbutamide increased levels of plasma insulin three to 18 times over fasting levels in normal animals but not in two spontaneously diabetic dogs.     

Total Ear Canal Ablation Clinical Results in the Dog and Cat

The clinical results of 39 consecutive ear ablations (in 28 dogs and three cats) performed over a 15-year period were reviewed. Indications for ear canal ablation included hyperplastic tissue stenosis of the horizontal ear canal (23), failed lateral ear resections (13), and horizontal ear canal neoplasms (3). Ear ablation was successful in alleviating persistent signs of otitis in eight of 15 dogs with horizontal ear canal stenosis due to hyperplastic tissue, seven of 10 dogs with unsuccessful lateral ear resections, and two of five animals (three cats and two dogs) with horizontal ear canal neoplasms (follow-up time periods greater than 5 months). Surgical complications occurred following 82% of the ablations; wound infections (41%) and facial nerve damage (36%) were most common. Local wound and antibiotic therapy successfully treated prolonged drainage following ablation in five of nine dogs. Bulla osteotomy and drainage were successful in the treatment of three dogs (four ears) that were unresponsive to medical therapy with postoperative ear fistula following ablation, one of two dogs with prolonged ear drainage following ablation for failed lateral ear resection, and one dog with recurrence of signs of inner ear disease following ablation (follow-up period, 1 month to 4 years; mean, 3.4 years). Facial nerve damage caused by ablation was transient in nine of 14 ears, with most deficits returning to normal within 2 weeks.     

宠物犬弓形虫病诊疗措施

弓形虫病属于一种分布范围非常广泛的人畜共患原虫病,幼犬、猫的发病率比较高。弓形虫宿主非常广泛,目前国内对弓形虫病的研究以家禽为主要研究对象,针对宠物犬弓形虫病诊疗及流行病学进行探讨对人类健康也有积极意义。     

Oral Cyclosporine Treatment in Dogs: A Review of the Literature

Cyclosporine is an immunomodulatory drug used to treat an increasing spectrum of diseases in dogs. Cyclosporine is a calcineurin inhibitor, ultimately exerting its inhibitory effects on T‐lymphocytes by decreasing production of cytokines, such as interleukin‐2. Although, in the United States, oral cyclosporine is approved in dogs only for treatment of atopic dermatitis, there are many other indications for its use. Cyclosporine is available in 2 oral formulations: the original oil‐based formulation and the more commonly used ultramicronized emulsion that facilitates oral absorption. Ultramicronized cyclosporine is available as an approved animal product, and human proprietary and generic preparations are also available. Bioavailability of the different formulations in dogs is likely to vary among the preparations. Cyclosporine is associated with a large number of drug interactions that can also influence blood cyclosporine concentrations. Therapeutic drug monitoring (TDM) can be used to assist in attaining consistent plasma cyclosporine concentrations despite the effects of varying bioavailability and drug interactions. TDM can facilitate therapeutic success by guiding dose adjustments on an individualized basis, and is recommended in cases that do not respond to initial oral dosing, or during treatment of severe, life‐threatening diseases for which a trial‐and‐error approach to dose adjustment is too risky. Pharmacodynamic assays that evaluate individual patient immune responses to cyclosporine can be used to augment information provided by TDM.     

Hemodynamic Changes During Laparoscopic Radiofrequency Ablation of Normal Adrenal Tissue in Dogs

Objective— To determine the hemodynamic response to radiofrequency ablation (RFA) of normal adrenal tissue in dogs.
Study Design— Experimental study.
Animals— Healthy adult mixed-breed dogs (n=6).
Methods— During general anesthesia a Swan–Ganz thermodilution catheter was flow directed into the pulmonary artery and used to quantify cardiac output. An arterial catheter was used for direct blood pressure measurements. An RFA device was introduced into the left adrenal gland under observation through laparoscopic instrumentation. Blood samples were collected and hemodynamic variables studied after a stable surgical anesthetic depth was achieved (time 1), during CO₂ insufflation of the abdomen (time 2), during adrenal RFA (time 3), and after completed RFA (time 4). Catecholamine determinations were performed with a human enzyme immunoassay. Histopathology was performed to verify medullary necrosis.
Results— Arterial, pulmonary arterial and central venous pressure, and plasma norepinephrine increased more during RFA than during abdominal insufflation. Heart rate and cardiac index did not differ between time points. High baseline epinephrine was present and significant differences between time points were not detected. Systemic vascular resistance had very high individual variation and differences were not detected.
Conclusions— RFA of normal adrenal tissues is associated with severe hemodynamic alterations. Further studies of the optimal blockage of catecholamine-induced hypertension in dogs are warranted.
Clinical Relevance— Clinicians should prepare for potential hypertensive crisis during RFA of adrenal masses, especially if treating a margin of normal tissue.