Surgery of the ear and pinna.

There are several disease processes of the ear and pinna that warrant surgical intervention. This article reviews surgical anatomy and common surgical procedures of the ear and pinna, including aural hematomas, lateral wall resection, vertical ear canal resection, total ear canal ablation and lateral bulla osteotomy, partial pinna resection, and feline inflammatory polyps. The clinical signs, diagnosis, and surgical treatment along with potential complications for each disease process are discussed.     

Prognostic factors for dogs with surgically resected gastrointestinal stromal tumors

Few reports have investigated prognosis of canine gastrointestinal stromal tumor (GIST) cases treated by surgical resection alone. In the present study, we investigated the overall survival (OS) and prognostic factors for dogs with GIST treated by surgical complete resection alone. Fifty-three dogs were included, and the median OS was 18 months. Multivariate analysis showed that primary tumors in small intestine (P=0.04) is significantly associated with shorter OS, and median OS of the cases with cecum lesion and those with small intestine lesion was 22 and 6 months, respectively. The present study suggested primary tumor site was a novel prognostic factor for dogs with GIST treated by surgical complete resection alone.     

Obstruction of equine small intestine associated with focal idiopathic eosinophilic enteritis: An emerging disease?

Idiopathic focal eosinophilic enteritis (IFEE) is a rare disease in the horse and few cases have been reported in the literature. The objective of this paper was to describe the clinical, surgical, histological features and post-operative progress of 12 horses with IFEE, a disease that had not been identified in the authors' hospital population prior to 2000. Diagnosis of IFEE was made at laparotomy and confirmed by histological examination of resected abnormal small intestine. In all 12 horses colic was associated with jejunal obstruction involving visibly striking and palpably thickened serosal plaques or circumferential constrictions. Surgical resection of affected intestine was performed in 10 horses, of which seven completely recovered. In one horse, on which surgical resection was not performed, ingesta re-obstructed post-operatively at one of the lesions. Histological examination of resected intestines revealed, in all cases, severe transmural enteritis in which eosinophilic leucocytes were the predominant inflammatory cells. No helminths were identified and the cause of this lesion is not known. IFEE is an uncommon but significant cause of small intestinal obstruction for which surgical resection can be curative. The gross lesions may be under-recognised and histology is essential for diagnosis.     

Wide Local Excision of Acanthomatous Epulides in the Dog

Twenty-five dogs bearing acanthomatous epulides of the oral cavity underwent tumor resection by wide local excision. The surgical procedures included rostral mandibulectomy, removal of the mandibular body, premaxillectomy, and partial maxillectomy. Postoperative complications were rare, and local recurrence was not encountered in any dogs over periods of 1 to 6 1/2 years (median, 22 months). The authors conclude from the high incidence of local recurrence after simple excision through the tumor margins and the potential for malignant transformation after irradiation that wide surgical resection is the technique of choice for the management of acanthomatous epulis.     

Intussusception in dogs and cats: A review of 36 cases

Intussusception is recognized as a common cause of bowel obstruction in small animals. This study documents the clinical and surgical findings in nine cats and 27 dogs diagnosed as having intussusception. The main purposes of the study were to define the predisposing causes and clinical signs of intussusception and to evaluate various surgical techniques commonly employed in its treatment. No common predisposing cause could be established. Diagnosis of intussusception was based most often on clinical signs of bowel obstruction in association with the palpable abdominal mass. The majority of the intussusceptions involved the enterocolic junction. Formation of adhesions was more frequent in cats. Surgical treatments included simple reduction, manual reduction with plication, intestinal resection/anastomosis, and intestinal resection/anastamosis with plication. There was no statistically significant difference (p>0.05) in the recurrence rate of the intussusceptions when the various surgical techniques were compared. Recurrence of an intussusception was not related to either the bowel segment involved or whether a simple reduction, bowel resection, or intestinal plication was performed at the initial surgery.     

A urethropexy technique for surgical treatment of urethral prolapse in the male dog

Urethral prolapse is an uncommon condition affecting young male dogs, most commonly English bulldogs. Current described techniques for surgical treatment of urethral prolapse involve manual reduction of prolapsed mucosa and placement of a temporary purse-string suture at the penile tip, or resection of the prolapsed tissue and apposition of urethral and penile mucosa. The incidence of recurrence of urethral prolapse following resection of the prolapse is not known. This report describes a technique for surgical treatment of urethral prolapse in the male dog that minimizes surgical and anesthetic time, is simple to perform, requires minimal equipment, is effective, and is not associated with significant complications or recurrence. Three cases are described.     

Advances in surgical treatment of septic arthritis of the distal interphalangeal joint in cattle: a review

This review describes the indications for surgical treatment of distal interphalangeal joint (DIJ) infection in cattle and presents an overview of former surgical methods that have been modified for current use, including arthrotomy, resection of the distal sesamoid bone, resection of the DIJ and digital amputation. The post-operative life span, reasons for culling, pros and cons of claw-preserving techniques versus digital amputation, and pain management in general are also discussed. It would appear that severe claw diseases that result in septic arthritis of the DIJ do not necessarily lead to a reduced life span if cows are adequately treated and thorough aftercare is provided.     

小型宠物犬阴道巨型肿瘤切除术

介绍宠物狗阴道巨型肿瘤切除术以及后续治疗过程。由于肿瘤太大,不适合阴户手术切除,在不具备微创手术条件下,采取腹背侧切开,避开大血管、神经、直肠、尿道等,暴露阴道,用环状钳把阴道牵引至体外,切开阴道,行环状肿瘤切除。目前该患犬状态良好。本文旨在为临床上该疾病的治疗提供参考。     

Results of operative treatment of equine colic with special reference to surgery of the ileum

This retrospective study presents the results of surgical treatment of obstructive colic in horses operated in the last decade (1976-1985). The overall short-term recovery rate (i.e. discharged from hospital) was 51% of cases presented for surgery, and 68% of cases which were considered to be amenable to surgical therapy. For long-term results (6 months-8 years follow up) these percentages must be reduced by about 15% due to mortality after discharge. Special attention has been given to surgery of the ileum, which is often involved in strangulation or obturation, and accounts for about 26% of gastrointestinal surgical disorders. The long-term recovery rate of ileal surgery was 54.3%, but ileocaecal intussusception and jejunocaecostomy with resection have a much poorer prognosis. The results of this study indicate that resection of the ileum should be avoided unless necrosis is present or threatening. The alternative is creation of a shunt between (distal) jejunum and caecum, thus bypassing the ileum and ileocaecal junction and preserving the original anatomical relationships.     

Comparison of perioperative versus postoperative intratumoral administration of cisplatin for treatment of cutaneous sarcoids and squamous cell carcinomas in horses

OBJECTIVE: To determine the benefits of reducing the interval between surgical cytoreduction and intratumoral administration of cisplatin. DESIGN: Randomized clinical study. ANIMALS: 70 horses with 89 incompletely resected T2- and T3-stage sarcoids (n = 64) and squamous cell carcinomas (25). PROCEDURE: Horses were given 4 intratumoral treatments of cisplatin at 2-week intervals. The first treatment was given at the time of, or immediately after, surgical resection for horses treated in accordance with the perioperative protocol (group 1). Horses in group 2 were treated with cisplatin after the skin healed following surgical resection in accordance with the postoperative protocol. RESULTS: A difference was not found in duration of overall local tumor control between the 2 groups. Patterns of treatment failures and interval to failure differed between the 2 groups. Length of the surgical scar was the only factor that affected prognosis; an increase in length was associated with a poorer prognosis. A detrimental effect of postoperative treatment was only found in tumors with a high tumor proliferative fraction. Local reactions were similar for the 2 treatment groups, and chronic reactions were not observed. CONCLUSIONS AND CLINICAL RELEVANCE: Intratumoral administration of cisplatin is beneficial for treatment of cutaneous tumors in horses. Tumor repopulation during the interval between surgery and intratumoral administration of cisplatin decreases treatment efficacy. These results provide evidence of rapid tumor repopulation following surgical resection without a lag period for tumors with a high proliferation index. When tumor proliferation index is not known, it may be prudent to use the perioperative protocol.     

Treatment of septic common digital extensor tenosynovitis by complete resection in seven horses

OBJECTIVE: To describe and evaluate a technique for radical resection of the entire intrathecal component of the common digital extensor tendon (CDET) in horses. STUDY DESIGN: Prospective clinical study. ANIMALS OR SAMPLE POPULATION: Seven client-owned horses. METHODS: Seven horses with wounds that resulted in septic tenosynovitis of the CDET sheath were treated by complete surgical resection of the affected tendon and ablation of the tendon sheath; 5 had previous surgery that was unsuccessful. Time from initial injury to complete resection was 1-22 weeks. In 6 horses, the wound was closed primarily using a closed suction (4 horses), penrose (1), or passive open drainage system (1). In 1 horse, the surgical wound healed by second intention. All horses had postoperative bandaging, antibiotic administration, and physiotherapy. RESULTS: Surgical wounds healed primarily in 6 horses and by second intention in 1 horse. Follow-up (mean, 26.4 months; range, 18-38 months) was available for 6 horses; all returned to their athletic performance level without lameness or gait abnormality. CONCLUSIONS: Complete resection of the CDET was an effective surgical technique for management of chronic septic tenosynovitis. CLINICAL RELEVANCE: Horses with infection of the CDET and its sheath may be returned to long-term soundness without gait abnormality after radical resection.     

Surgical approach for tentorial meningiomas in cats: a review of six cases

The surgical technique for removal of tentorial meningiomas is described on six cats using a unilateral temporal supracerebellar transtentorial approach. Complete gross tumour resection was achieved in four of six cats. In one cat, only subtotal resection was achieved. One cat died shortly after surgery because of extensive cerebral haemorrhage. The surgical approach, combined with cisternal or ventricular cerebrospinal fluid puncture and an open-window technique (tumour fenestration and enucleation) provided sufficient visibility and tumour accessibility without excessive manipulation of the brain parenchyma. In all patients, a postoperative transient worsening of the clinical signs was observed. The neurological signs resolved with time with the exception of blindness in two cats. All five surviving cats were monitored for a mean follow-up time of 19 months (median 20 months; range 6-30 months). All patients died or were euthanased because of tumour regrowth within the follow-up period. Although challenging, surgical treatment is a useful therapeutic measure in the treatment of cats presenting with tentorial meningiomas.     

Successful management of 3 dogs with colonic pythiosis using itraconzaole,terbinafine, and prednisone

Gastrointestinal (GI) pythiosis is a severe and often fatal disease in dogs that traditionally has been poorly responsive to medical treatment. Although aggressive surgical resection with wide margins is the most consistently effective treatment, lesion location and extent often preclude complete resection. Recently, it has been suggested that the addition of anti‐inflammatory doses of corticosteroids may improve outcome in dogs with nonresectable GI pythiosis. This report describes 3 dogs with colonic pythiosis in which complete resolution of clinical signs, regression of colonic masses, and progressive decreases in serological titers were observed after treatment with itraconazole, terbinafine, and corticosteroids. This treatment protocol represents a promising treatment for dogs with GI pythiosis in which surgical intervention is not feasible.     

Prepuce and partial penile amputation for treatment of preputial gland neoplasia in two ferrets

Preputial tumours in ferrets are frequently malignant and therefore warrant prompt investigation. As many cases do not respond favourably to surgery, even in combination with radiation therapy, wide surgical resection has been recommended. Such a procedure may necessitate partial or total penile resection but outcomes have thus far not been well described. The current case series describes two ferrets in which surgical resection, including penile amputation, was performed using 10 and 5 mm margins, respectively. In the first case, no recurrence of preputial gland adenocarcinoma was noted for 32 months postsurgery, whereas multiple attempts at surgery and radiation therapy were unsuccessful in the second. These cases suggest that margins of at least 1 cm may help achieve a better outcome. Penile amputation for the treatment of preputial tumours appears to be well tolerated by ferrets, as demonstrated by these cases.     

Surgical management of otitis externa

The surgical management of otitis externa is discussed in conjunction with failed medical management, primary causes, and proper case selection. The techniques of lateral ear canal resection and vertical ear canal ablation are described in detail.     

Cervical dermoid sinus in a cat: case presentation and review of the literature

A 6-month-old female spayed domestic shorthair cat was presented for evaluation of a focal subcutaneous swelling on the dorsal neck at the level of atlas. The magnetic resonance imaging and surgical treatment of a dermoid sinus associated with the cervical vertebrae is described. To the authors' knowledge, a dermoid sinus in this location has not been described previously in the cat. The prognosis following surgical resection appears favorable.     

Photodynamic therapy for the treatment of periocular squamous cell carcinoma in horses: a pilot study

Objective  Local photodynamic therapy (PDT) is a novel cancer therapy in veterinary ophthalmology. A prospective pilot study seeking to demonstrate proof of principle and safety for the treatment of equine periocular squamous cell carcinoma (PSCC) was therefore conducted. We hypothesized that surgical excision with adjunctive local PDT is an effective and safe treatment for equine PSCC.
Procedures  Nine horses (10 eyes) with PSCC were treated with surgical resection, local infiltration of resulting wound beds with 2-[1-hexyloxyethyl]-2-devinylpyropheophorbide-a (HPPH) and irradiation with 665-nm wavelength diode laser. Regular follow-up ophthalmic examinations were performed.
Results  Surgical resection and PDT yielded disease-free intervals of 25–68 months in our study horses as of January, 2008. These results were obtained following a single treatment in seven horses and two treatments in one horse. In one horse, carcinoma in situ developed 2.5 months after partial surgical excision and PDT, requiring local excision under standing sedation.
Conclusions  Preliminary results suggest that surgical resection and adjunctive local PDT is a safe and effective novel treatment for PSCC in horses. More research is needed before PDT for the treatment of equine PSCC can be adequately compared with other current modalities. Important to future investigations regarding PDT, tumor recurrence rate, length of hospitalization, number of treatment episodes required to effect tumor remission, and total treatment costs should be examined in a controlled manner. Our present results and experiences suggest that this treatment may be useful in the treatment of equine PSCC.     

A Report on the Sexual Cycle in the Kudu Bull Tragelaphus Strepsiceros Pallas and a Description of an Inter-Sex

The tendency of trauma to the eye, especially in the cases of infected perforating wounds or of parasitic infections, to involve all structures of the eye, is outlined and the need for surgical treatment is discussed. Difficulties and problems in operative procedures arising from the varied manifestations of panophthalmitis, particularly with regard to anaesthesia, immobilization, excision and resection of tissues, drainage and postoperative dressings, and the methods of overcoming them, are described on the basis of nineteen surgical cases.     

Intra‐operative imaging of surgical margins of canine soft tissue sarcoma using optical coherence tomography

Optical coherence tomography (OCT) is a rapid non‐invasive imaging technique that has shown high sensitivity for intra‐operative surgical margin assessment in human breast cancer clinical trials. This promising technology has not been evaluated in veterinary medicine. The objective of this study was to correlate normal and abnormal histological features with OCT images for surgical margins from excised canine soft tissue sarcoma (STS) and to establish image evaluation criteria for identifying positive surgical margins. Fourteen client‐owned dogs underwent surgical resection of a STS and OCT imaging of 2 to 4 areas of interest on the resected specimen were performed. Following imaging these areas were marked with surgical ink and trimmed for histopathology evaluation. Results showed that different tissue types had distinct characteristic appearances on OCT imaging. Adipose tissue exhibited a relatively low scattering and a honey‐comb texture pattern. Skeletal muscle and sarcoma tissue were both dense and highly scattering. While sarcoma tissue was highly scattering, it did not have organized recognizable structure in contrast to muscle which showed clear fibre alignment patterns. In this investigation, we showed different tissue types had different and characteristic scattering and image texture appearances on OCT, which closely correlate with low‐power histology images. Given the differentiation between tissue types the results support that OCT could be used to identify positive surgical margins immediately following resection of STS. Further research is needed to assess the diagnostic accuracy of this method for surgical margin assessment.